Medical bungling most likely killed Garfield

Frederick N. Rasmussen, The Baltimore Sun

Baltimoreans were astonished to find resting on their porches and steps early on the morning of July 3, 1881, an "Extra" edition of The Baltimore Sun.

This was a first time in The Sun's 44-year history that the paper had been printed on a Sunday, and it was for urgent reasons. (It would not regularly start publishing a Sunday edition for another 20 years, on Oct. 6, 1901.)

The gravity of the extra was instantly obvious. It told of the attempted assassination of President James A. Garfield in a Washington railroad station, as he was about to board a train with his two sons for a visit to his wife, Lucretia, who was recuperating from a case of malaria on the Jersey Shore at Elberon.

Ominous headlines said it all:

TELEGRAPHIC NEWS. FROM WASHINGTON. ATTEMPTED MURDER OF THE PRESIDENT. ARREST OF THE ASSASSIN. GRAPHIC ACCOUNT OF THE SHOOTING. A SKETCH OF THE WOULD-BE MURDERER. THE PRESIDENT STILL ALIVE. HIS CONDITION HOPEFUL.

"The change from the busy but to most men the trifling rivalries and intrigues of political life at the nation's capital to the sharp, clear-cut occasion when a pistol-shot echoes through the world and brings all suddenly to a reality that all men can appreciate, to life and death, is a change not often made here," reported the newspaper.

"These few occasions are the cameos of history, cut and set into the solid stone that makes imperishable history. The mad attempt upon the life of James A. Garfield, President of the United States, by Charles Guiteau, at the depot of the Baltimore & Potomac Railroad yesterday, was such an occasion."

Medical bungling, which would claim Garfield's life 80 days later, began immediately when the stricken president, still lying on the station floor, was attended by Dr. Smith Townsend, the first physician to arrive on the scene.

He probed Garfield's wound, inserting an unsterilized finger, in search of the bullet. He almost certainly introduced "an infection that was far more lethal than Guiteau's bullet," writes Candice Millard in her recently published "Destiny of the Republic."

Removed to a second-floor room, Garfield turned to another physician, Dr. Charles Purvis, and asked what his chances were. "One chance in a hundred," Purvis replied. "We will take that chance, doctor, and make good use of it," said the president.

Standing in the room was Robert Todd Lincoln, son of the murdered president and Garfield's secretary of war. He suggested that Dr. D. Willard Bliss, who had attended his father, be brought into the case.

Lincoln, in addition to being present when his father died, was in the station that morning with Garfield and was also with President William McKinley when he was assassinated in Buffalo, N.Y., in 1901.

Like Townsend, Bliss, who was considered something of a quack, had little regard for the theories of Dr. Joseph Lister, who had founded and was a vocal proponent of antiseptic surgery, at a time when surgeons wielded unsterilized instruments in multiple surgeries while dressed in bloody gowns.

At the time, the seriously ill or injured naturally feared hospitals, which were considered nothing more than pesthouses from which few souls who entered emerged alive.

Garfield was transported to the White House from the station. There for the next 80 days, doctors — who grew to a team of 10, all of whom had unwashed hands — probed the wound, unsuccessfully searching for the elusive bullet, while removing particles of bone and fabric.

Alexander Graham Bell, inventor of the telephone, arrived in Washington with an electrical device he called the Induction Balance.

Medical advisers reassured Bell that there was no metal in the bed that would throw off the probe, but they failed to realize that underneath the horsehair mattress were steel wires.

Bell was unable to locate the bullet.

If Garfield had had the benefits of X-ray, which came 15 years later, the bullet, lodged beneath the back in the fatty tissue near the pancreas, would have been instantly located and removed, ensuring his survival.

Wishing to go to Elberon, N.J., Garfield was transported on Sept. 6 by a special Pennsylvania Railroad train. To minimize the president's discomfort, a 3,200-foot spur had been hastily constructed so the train could stop at the front door of the presidential cottage.

Garfield's medical condition, as a raging infection overwhelmed him, deteriorated over the intervening days, until his death Sept. 19. He was 50 and had served a little over five months.

THE END OF A NOBLE LIFE, opined The Sun.

Garfield's funeral train would pass through Baltimore twice, on the trip from Elberon to Washington, and then on Sept. 23 from Washington to Cleveland for burial.

After making a brief stop for an engine change, the six-car train departed Baltimore at 5:16 p.m., going westward over the Northern Central Railroad, as city church bells tolled and crowds witnessed its "melancholy passage through the northern suburbs of Baltimore," reported The Sun.

Guiteau, dressed in a freshly pressed suit and shined shoes, was executed June 30, 1882, in the yard of the District Jail.

At the conclusion of a prayer he had written — "I am going to the Lordy, I'm so glad" —Guiteau dropped the poem, and the executioner sprang the trap.